COVID 19 and Tuberculosis: Focus on vulnerable communities

Tuberculosis (TB) is the fifth killer disease in Kenya and the world’s leading infectious disease killer. According to the World Health Organization (WHO), nearly 10 million people were affected and 1.5 million deaths were reported in 2018. Although TB has had profound impact in Kenya, over the years, the nation has made great strides in the fight against TB. The COVID-19 pandemic, however, has posed a great threat to the achievements made so far. What is important is to ensure that as a country, we protect the lives of people with TB and provide essential services like early TB diagnosis and treatment. The National TB program has been at the forefront not only to support the Ministry of Health in the fight against COVID-19 but also in ensuring that TB services are maintained. Finding and treating people with TB remains one of the fundamental pillars of the National Strategic Plan (2019-2023).

The provocation of social stigma as a result of the COVID-19 pandemic not only undermines our social cohesion but also promotes social isolation particularly of risky groups like those affected by TB. This according to the World Health Organization (WHO) can; drive people to hide the illness to avoid discrimination, prevent people from seeking health care immediately, or even discourage them from adopting healthy behaviours. All key stakeholders including media and communities should be supportive by demystifying the myths around the TB and COVID-19. This is important in safeguarding the continuity of prevention, diagnosis, treatment and care for people with TB in our communities.

COVID-19 is an illness that mainly affects the lungs and airways and is caused by a new coronavirus. Those who contract it may show similar symptoms to TB such as coughing and fever. TB patients, if infected, may suffer from more severe forms of COVID-19 just like those with weak immune systems. COVID-19, just like TB, is easily spread in densely populated areas due to proximity to others.

COVID-19 spreads when someone with the virus coughs or sneezes and releases droplets into the air. Anybody nearby who breathes these droplets in could get infected. The spread can also be through touching our faces after touching surfaces that have the droplets or the virus. Those diagnosed with pulmonary TB and have any damage on their lungs are more vulnerable to other infections including COVID-19. Those with latent TB but in good health are unlikely to be at more at risk from COVID-19 than the general population.

When it comes to prevention for both TB and COVID-19, there are several effective measures we should put into consideration including; using disposable tissues when coughing and sneezing and washing our hands or use hand sanitizer, regularly wash our hands for 20 seconds each time with soap and water or use hand sanitizer, especially when we get home or to work, blow our nose, sneeze or cough, or handling food, avoid touching faces with unwashed hands, avoid close contact with people who are unwell without protective gear and taking all medications as prescribed for those being treated for active TB.

People with TB and COVID-19 may experience cold and flu-like symptoms and it important they seek quick medical advice. The most common symptoms include:

Symptoms of COVID-19 usually appear quickly and disappear after about seven days. Symptoms of TB appear gradually over several weeks and persist if they are not treated
TB patients need to take all medication as prescribed even when they fall ill with COVID-19. The doctors or nurses in charge should advise accordingly. Those cured of TB and have no other health conditions will have similar COVID-19 risks just like the general public. However, former TB patients who had lung surgery or with post TB lung disorders are considered to be at high risk thus the need to protect themselves.

As we struggle to deal with the COVID-19 pandemic, we must ensure that the impact of this pandemic does not create another tragedy for vulnerable communities like people with TB. Already, our health system is under considerable pressure. The Ministry of Health, county governments, partners and other key stakeholders should endeavour to ensure that essential TB services are maintained. The use of technology like Keheala can also come in handy. The TB program should incorporate innovation that will access to treatment through community health workers and follow-ups of patients through telemedicine and the TIBU system. The program should also ensure supplies; particularly medicines, personal protective equipment, and lab reagents reach all facilities on time. Better collaboration will reduce the risk that TB patients have and sustain the gains we have made.